Faced with a disease, we often get lost, the earth seems to be slipping away from under our feet. Thierry Jansen invites us to rethink this trial in order to find hope that brings healing.
Psychologies: You pose an unexpected question: what is the meaning of illness? So, the answers that modern medicine gives him are not enough for you?
Thierry Jansen: Our modern Western medicine is very effective and can do a lot, but it only addresses our physical body, the “body-object”, and is not interested in the psychological dimension of a person, the “body-subject”. Having decomposed the human body into components — organs, cells, molecules — and having studied their structure, medicine forgot about the connections that create a whole from these individual parts. Meanwhile, it is these connections that make a person a person and connect him with the world. Often, when a patient goes to a doctor, it seems to him that he is only dealing with him from the “mechanical” side: “The doctor treats my tumor, not me.” I think that medicine has gone too far in its «purely biological» perception of man. Today we need to change this idea, to «animate» the bodily mechanism. To see in the body a soul that thinks, dreams, hopes, feels…
Do you think that illness is a kind of call to order coming from our psyche?
T. Ya.: Illness is a crisis, it poses questions for us: “How did it happen that I got sick, why am I sick?” Illness is both a danger, because we risk a lot, and a chance, an opportunity to understand what we are … and change. This is an invitation to growth, to development. Face to face with the disease, we lose the usual guidelines, we become like children. In any human culture, there are systems for explaining the phenomenon of disease, which are designed to structure this chaos. In different worldviews and among different peoples, we find archetypal concepts of balance, harmony, beauty, on which the idea of health is based. In addition, the idea of collective responsibility towards life is everywhere present. The experience of chaos given to us in illness acts like a prick, reminding us of a fundamental need in a sense that is inherent in our nature.
Three conditions of our health
Thierry Jansen believes that for physical and mental health, first of all, you need a free, flexible body that is in motion, correlated with a plastic, flexible consciousness that can doubt and change. To achieve this, you need to trust yourself and life. The more we trust ourselves and the world, the easier it is for us to remain plastic, changing. Conversely, the more plastic we are, the more we tend to trust ourselves. Trust and plasticity are two qualities that lead us to come to terms with ourselves, and this, in turn, is necessary so that we can fully realize our life purpose.
Can illness have a single, universal meaning?
T. Ya.: No. The ambiguity of the disease is already reflected in the existence of different words for its designation: “ailment”, “malaise”, “illness”, “disease”, “disorder” … There are at least three semantic facets that, for example, are successfully reflected in English. To denote the biological side, there is the word desease (disease), which explains the material, organic nature of the phenomenon. The concept of illness also includes the meaning of subjective ill health, internal trouble, poor health, which expresses the English illness. There is a third, equally important, understanding of illness as a social phenomenon — sickness, which characterizes illness as a sociocultural phenomenon and considers it as a problem for the entire human community.
It turns out that the main thing is not to look for the meaning of the disease, but to give it a meaning ourselves?
T. Ya.: Exactly. Viktor Frankl, an Austrian psychiatrist who ended up in a German concentration camp during World War II, observed that prisoners were more likely to survive if they could make sense of their suffering*. To give meaning to what one experiences is to create the possibility of hope. It is she who helps to survive in a situation of absurdity. It allows you to see yourself in the future, to experience positive emotions that are vital for the normal functioning of our body. The same thing happens in the face of illness. My experience of studying indigenous peoples, such as the Australian Aborigines or the Cameroonian Duala, led me to the conclusion that by giving meaning to a disease, one thinks that one can affect it. If you believe that you are a victim of fate or the evil eye, then you can pray to a deity or beg a sorcerer, which are the cause of misfortune. I can also enter into a dialogue with my suffering and say to myself: my situation is the result of bad habits. If I change my habits, tweak the course of things a little, then I will gain power over the disease.
And is that enough to get better?
T. Ya.: Not really. Modern research shows that hope and positive emotions enhance the recovery processes and immune defenses of the body. If we want to help the body heal, the psychological side must be taken into account — of course, by continuing the prescribed treatment. At the same time, one must resist the temptation to achieve an absolute coincidence of the symbolic meaning of the disease and its biological nature, otherwise we risk confusing the interpretation of the symptoms of the disease with its real causes.
In other words, is it dangerous to try to explain everything by “psychology”?
T. Ya.: Quite right. One must be careful about such interpretations, in which the disease is considered solely as a physical expression of psychological problems and internal conflicts. Some psychotherapists go so far as to claim that being aware of and resolving emotional conflicts can itself cure ailments such as cancer. This is dangerous, since most diseases arise as a result of a whole range of reasons: heredity, lifestyle, mental trauma, infections, diet … Psychological stress is just one of these factors. It would be absurd to offer a ready-made explanation like: «Throat cancer is the result of a person not being able to say what he thinks,» not taking into account the fact that this person smoked two packs a day. Some patients who have been convinced that their condition is purely psychological in nature interrupt treatment and switch completely to psychotherapy, and then feel guilty for “failing to do it,” have not been able to recover.
Where is the line between self-accusation and awareness of responsibility?
T. Ya.: No one is to blame for their illness. At the same time, we must learn to take responsibility for our health. Among the many factors that lead to the disease, there are those that can be excluded. Prevention is better than cure. So to give meaning to the disease also means to realize our responsibility for the processes that caused it, and to decide to change our habits and lifestyle. This is our real power over disease. Its meaning, therefore, must be understood in two ways — simultaneously as «why?» and how «why?». It allows us to choose a new direction for our existence, to achieve a new harmony.
How to achieve it?
T. Ya.: Each of us is unique, each has its own story. Therefore, it is necessary to help the patient find his own meaning in suffering, avoiding ready-made solutions and respecting his special inner world. Modern medicine leaves little room for this range of questions. Psychotherapeutic support of patients as an addition to treatment could provide invaluable assistance to patients. Positive emotions that arise in the process of psychotherapy would certainly contribute to recovery. It is about reaching harmony between body and soul. After all, the integrity of the human being is one of the fundamental components of recovery (see box on page 148). Self-consent means that we (re)acquire the unity of our thoughts, beliefs, words and actions. And you don’t have to wait for illness to start putting these healthy principles into practice. Prepared by Ksenia Kiseleva
* V. Frankl “To say yes to life!”. Psychologist in a concentration camp. Alpina non-fiction, 2009.